The first area focuses on policy issues related to the financing and delivery of medical care to the elderly. This application describes the first of several studies planned in this area, an analysis of health maintenance organization (HMO) performance for elderly patients. This study will compare HMO and free-for-service utilization of health services for the very ill, by comparing utilization during the last year of life. The second area of research will compare and validate methods for assessing functional status among geriatric outpatients. In the first phase of this research agenda, existing instruments will be compared and their validity will be tested among outpatients over the age of 75. Later during the five year period, the value of providing physicians functional information will be examined in a randomized trial.